The American Military Partner Association (AMPA) is the nation’s largest organization of the partners, spouses, families, and allies of America’s lesbian, gay, bisexual, and transgender (LGBT) service members and veterans. With over 40,000 members and supporters, AMPA is committed to education, advocacy, and support for our “modern military families.” Find out more about AMPA at www.MilitaryPartners.org

The Transgender American Veterans Association (TAVA) acts proactively with other concerned LGBT organizations to ensure that transgender veterans receive appropriate medical care through the Department of Veterans Affairs (VA) and helps educate the VA and the Department of Defense (DoD) on issues regarding fair and equal treatment of transgender and transsexual individuals. Find out more about TAVA at www.TAVAUSA.org

LEAD AUTHOR

Gene Silvestri is a transgender U.S. Army disabled veteran. He served with the 14th Military Police Brigade, 787th Battalion in Fort Leonard Wood, Missouri, where he received an honorable medical discharge in 2003. Gene is the Veterans Affairs Coordinator for the American Military Partner Association (AMPA), serves as a board-member-at-large for the Transgender American Veterans Association (TAVA), and is on the board of the Sacramento Valley Veterans (SVV), a local chapter of American Veterans For Equal Rights (AVER). In August 2013, Gene was appointed to the role of Vice-Chair of the Committee on LGBT Veterans of the Veterans Caucus of the California Democratic Party, and in November 2013, Gene was nominated and elected to the Executive Board of the Veterans Democratic Club of Sacramento. Through these organizations, Gene continues to advocate for the rights of all service members, veterans, and their families locally and nationally.

Transgender people have served, and will continue to serve, bravely and proudly in the United States military. Findings in a Williams Institute study “Transgender Military Service in the United States” show that “nearly 150,000 transgender individuals have served in the U.S. armed forces, or are currently on active duty.” Despite the numbers, outdated military medical policies and regulations prevent transgender people from serving openly and honestly, harming both transgender service members and their families.

In September 2011, Congress took a step towards creating a more inclusive environment in the military by repealing the discriminatory “Don’t Ask, Don’t Tell” (DADT) law, which prevented gay, lesbian, and bisexual troops from serving openly and honestly. Despite this historic progress however, the repeal did not lead to full military inclusion for our transgender service members who continue to be barred from service by outdated military medical regulations.

In the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association identifies the “condition in which people whose gender at birth is contrary to the one they identify with” as “gender dysphoria.” Unfortunately, the Pentagon continues to classify gender dysphoria as a “psychological condition deeming one unfit for service.” This in effect forces service members who do not conform to the sex they were assigned at birth to hide a fundamental aspect of their being, their gender identity. As long as this ban on open and honest service is enforced, transgender service members and their families are often faced with the dehumanizing and unjust decision of choosing between serving their country and living authentically.

Findings in the National Transgender Discrimination Survey (NTDS) of 2011 suggest that transgender military service currently “occurs at a rate double that of the general population.” The report also highlights that “20% of all respondents said they are or had been a member of the armed forces” as opposed to “10% of the non-transgender U.S. population had served in the military.” The numbers clearly show transgender individuals continue to seek enlistment or commissioning within the armed forces despite facing an unfair disqualification from service. Under this unjust ban, there are approximately 15,500 transgender service members actively serving.

Current military regulations prohibit transgender persons from enlistment into the armed forces, regardless of whether they have medically transitioned or not. These antiquated policies and regulations are inconsistent with medical and psychological advancements concerning the comprehensive full scope of transgender health care. In sharp contrast, while transgender people are currently prohibited from serving openly in the United States, at least eighteen other nations allow open transgender military service in some capacity. These countries include: Australia, Austria, Belgium, Bolivia, Canada, Czech Republic, Denmark, Estonia, Finland, France, Germany, Israel, Netherlands, New Zealand, Norway, Spain, Sweden, and the United Kingdom. Transgender service members and these nations’ militaries as a whole are operating effectively and efficiently, further proving that gender non-conformity is not a barrier to performing one’s duties.

In a March 2014 Palm Center report, the Transgender Military Service Commission found that “there is no compelling medical rationale for banning transgender military service, and that eliminating the ban would advance a number of military interests, including enabling commanders to better care for their service members.”

BAN’S HARMFUL IMPACT ON MILITARY FAMILIES

When discussing military regulations, often times the family is overlooked or forgotten about, but it is important to remember that many transgender troops are married and/or have children. The ban poses harmful consequences to the entire family unit, not just the service member. As you’ll read in the following section’s personal testimony, under the current ban, the families of transgender service members are forced into the shadows, leaving these military families no other option but to lead double lives and unfairly cutting them off from the support they need and deserve.

As long as the military continues to enforce antiquated medical regulations, the entire family is subject to the ban’s harmful impact. They are exposed to the same levels of risk, discrimination, and humiliation that transgender service members face, left with no choice but to serve in silence along with their service member. The entire family unit shares in the burden of having to live a double life, forced to keep their loved one’s true gender identity concealed. Often times, they remain helpless, witnessing the pain and torment their loved one experiences as a result of overwhelming pressure from the ban.

Family members of transgender service members are faced with unfair barriers and unique challenges beyond what most military families are familiar with. Not only is the transgender service member exposed to continued discrimination, their family members also become subject to possible unwarranted physical and verbal abuse, as well as various health care barriers. Misconceptions about medical procedures or treatments present challenges in accessing appropriate health care. Service members who are parents of transgender children have difficulties receiving comprehensive health care for them as TRICARE has exclusions on transgender related health care coverage. As a result, they are left dealing with high health care costs.

Transgender service members and family members may also go without necessary medical and mental health care out of fear of exposure and ignorance. The threat of discharge weighs heavy on these families because at anytime, their loved one could possibly be discharged from the military simply because they are “transgender or gender non-conforming.”

TESTIMONY FROM MILITARY FAMILIES

US Army Family

Service Member:

“Despite an administrative ban on transgender service members, we are willing to push ourselves and hide our true selves to serve our nation. Both my spouse and I are transgender, and as a married soldier to a civilian transgender man, we have a unique story to tell because the roads to our transitions have been more challenging than the average person.

For my spouse, we’ve attempted to get him the medical help he needs through the local military treatment facility. In March 2013, I contacted Tricare in reference to their (previous) policy on hormone replacement therapy. As it then stated, he was authorized to use it as prescribed by the primary care manager (PCM) and any additional rules that the medication would have. We took that policy to the doctor and got the go ahead to get my spouse the medical help he needs to live a healthier, positive and productive life.

During one of his appointments with an alternate military doctor who wasn’t his PCM, the doctor took the appointment time to berate him. He wouldn’t tell me what was told to him, but he left the appointment in tears and has postponed his transition until we leave the area, or I’m able to transition alongside him. Because the military’s official non-discrimination policy does not include sexual orientation or gender identity, we felt as if we had no way to address the harassment. In the end, my spouse left the situation even more untrusting of the military medical system, and he refused to go into the doctors for anything less than dire emergencies. I only just recently convinced him to go in for his heart because his heart palpitations were getting much worse when I deployed. Even then, after the surgery he only went back for a post-operation check up and has since refused to go back.

Unlike many of my peers and superiors, I haven’t started to medically transition in uniform. The biggest reason why stems from my time at Fort Belvoir, VA, for AIT when I went through a horrible DADT witch-hunt. The impact of the witch-hunt was so traumatic that it led to an attempted suicide, one of my closest friends going AWOL (she eventually turned herself in, I still have no idea what became of her) and the rest of us on edge and questioning the Army’s leadership. I was terrified, worried, and sustained an unrealistic level of paranoia that I uphold today in hopes that no one will ever find out that I’m a transgender woman.

The fear, pain, and frustration is so overwhelming that it has led me to contemplate suicide. Unlike a few service members who left and transitioned, and despite the reoccurring nightmares I still have, I cannot transition out of fear I’ll be discharged for my gender identity. I still hold deeply strong feelings about wanting to continue to serve in the Army, but I want to serve in a safe environment that leadership keeps talking about.

I originally served in the Army in hopes to disprove my mother’s own personal experiences when she served in the Army during the late years of the Cold War. She is a victim of sexual assault and was denied promotion and assignments because of her gender. I wanted to show her and my daughter that things are better, but I was wrong. Even during the age of post-DADT repeal, I still continue to have nightmares. I continue to have emotional outbursts and heavily drink in hopes to stave off these problems I face.

I don’t feel safe to transition to my authentic self in uniform, despite the success stories I see from friends. I feel so isolated and worthless. I cannot get help and feel as though I am stuck. I already hate myself for loving the Army so much that I’m willing to put myself though years of physical, emotional, and spiritual self-destruction to continue to serve. But I want to be a good example for my daughter, prove to my mom that things are getting better, and help lead soldiers into a much stronger Army of tomorrow.

Despite all my awards, decorations, and achievements, I feel hollow and depressed. I want to continue to serve at the same high level of care and productivity, without succumbing to an outdated policy and even possibly by my own hands. I want to stand taller, as a service member who is valued and appreciated. I want to be able to come home with pride in service. I’ve already proven my commitment to the Army and our nation. I just want to get the help I need so I can continue to serve without the fear, anxiety, and depression of not being able to be my authentic self.”

US Navy Family

Service Member:

“It’s hard for me to put into words how I feel being transgender in the military. Being transgender is a hard thing to explain to begin with, and to describe how it affects my life serving this country is almost as hard.

I am forced to be two separate people. I have a wife and children that see me as the man I am and love me for all of my faults and strengths. I have a career that I love very much and yet, not only do I have to hide the most obvious part of me, lie to close friends, and act like one of the girls who looks like a boy, but I have to live in fear. I have to ignore the looks and stares as I walk by a new female check-in in my berthing on my way to my bunk. I have to ignore the awkwardness that comes when someone calls me ‘sir,’ then only to be corrected by someone around me after I have returned a greeting. I am scared to answer the question at medical if I am my child’s father when picking up medicine for them.

I can’t change my name in fear of someone deciding that I shouldn’t get to wear the uniform that I am proud to wear. I can’t have my wife or children at any award ceremonies or advancement ceremonies because of my command “knowing” me as a female. I can’t have my wife or children go to any command functions in fear that someone will hear them say ‘daddy’ or my non-birth name.

I have uniforms that I do everything I can to not wear because they just look and feel wrong. I can’t go out with coworkers off duty because I could lose my job, my house, and my families’ security if the wrong someone sees me use the appropriate restroom or risk being attacked by using a female one.

I cannot give my job 100% devotion and focus because I’m too scared of them seeing ‘the real me.’ I have to censor myself before I talk about my life outside of work to anyone in the military in case they are the wrong someone. I am forced to hide, sneak, and lie my way through my entire life because the military is such a huge part of my life. It affects every part of me, and though I don’t want to change my career choice, it makes me question whether I can continue to put myself and my family through this until retirement. I hope that one day soon I can stand by my brothers and sisters and know that I am fighting for a country that supports me.”

Military Spouse:

“When I first found out that my husband was transgender, I had a hard time accepting what that meant for my life. I am a lesbian and his gender identity doesn’t change who I am. I remember the first time I realized how important it was for him to be able to transition from female to his authentic self as a male. We used duct tape and an ace bandage to tape down his chest so it looked more masculine. We then went to the mall to buy clothes that were more masculine. When he came out of the changing room the look of pride in his eyes broke my heart. It was that moment I realized I had to support him. That was 3 years ago.

I have grown a lot in 3 years. I have come to love the man underneath. The military ban on transgender individuals is the ONLY barrier our family has in living a happy, complete life. My husband lives in 2 worlds. At home he is a husband and a father. At work he is a female sailor. He is forced to live with females even though he is CONSTANTLY assumed to be male and has been yelled at for being in female berthing. My husband has had top surgery so he has a male chest. He has also been taking testosterone for a year and by doing so he is risking his job. My husband just got a promotion and really loves being in the Navy, aside from the times that people say ‘she’ or ‘her.’

In our day-to-day life, we have friends who don’t know that he was labeled a female at birth, and it’s not something we advertise. We are afraid to change his name legally. In the state of California, all we would have to do is bring a doctor’s note into the county clerk’s office and we could change his name and gender on his birth certificate. We are afraid to do that though because that is a red flag to the Navy. At the kids’ school, I have his male name written on the emergency cards, but since his ID is still in his female name, he cannot pick his own kids up from school. I feel like I’m living my life in a bubble. We are afraid to get close to any military families. My kids can’t go to welcome home ceremonies because it bothers them that their dad is wearing a female uniform. I am married to an incredible man who serves his country and wants to retire in the Navy. He shouldn’t be forced to lie about who he is to serve his country.”

Military Son – Age 12:

“We live in military housing and I go to a school with mostly military kids. It makes me sad when I see my dad wear a girl’s uniform. He should be allowed to wear a boy’s uniform. It’s weird to have a boy wear a girl uniform. Sometimes I’m a little nervous that people will find out and he will lose his job. I’m sad that whenever we get mail, it always says his girl name, but we want to change it legally to his boy name. I think he is sad that he can’t legally be a boy because he is in the military. I think of my dad as a normal dad. I don’t even know him any other way. We play video games, play football, we watch hockey and just do normal stuff that fathers and sons do. I don’t like that my dad has to keep being treated like a girl when he is a boy. DADT was a rule Obama knew was wrong, but now he needs to fix this rule because it’s wrong. My dad is going to deploy soon. He could go to war and be killed. He should be treated better than this.”

US Air Force Family

Service Member:

“I have been in the military for over 22 years and am a Lt Col in the USAF. I am proud to say that I outlasted DADT. I have been happily married for 15 years, and we have three beautiful children. I have been deployed to Iraq twice, once to Baghdad and once to Balad. I was also deployed to the Balkans and have been on long duty assignments away from my family.

I have been a transgender man for about 5 years. I don’t see myself as gay. Only in the last few years have I really understood the core of who I am. I am not a lesbian but a man born inside a woman’s body. I dare not speak of it because being perceived as a lesbian was dangerous enough. I made the realization when I was in Iraq, pinned down for the umpteenth time by insurgents. I was thinking that I did not want to die as a woman but with the dignity of the man that I feel I am. I decided that it would be something I would have to pursue when I retired because, above all, serving my country is first. I want to provide a safe place for my children to grow up and live. People have asked me why I don’t just get out and live my authentic life. The answer is simple. Freedom isn’t free and how can I ask for rights if I don’t stand to defend them.

My wife and children know that I am transgender. My son, who is 9, keeps asking how come I can’t live authentically so others can see the Dad he sees? My daughter will tell everyone that she is Daddy’s girl and has a shirt that says Daddy’s Princess. I have had to hide who I am for almost the entire 22 years of my career but not with my family.

There is an awards ball coming up and I have to be at the function. This means I must be in a mess dress. The thought of wearing that skirt sends me into a panic and depression like I can’t even explain. For my daily uniform, I wear the men’s Airmans Battle Uniform (ABU) and even the men’s jacket. There are so many constant reminders in the military that I cannot be myself, and it is very disappointing. I was very pleased that DADT fell, and that I could legally marry my wife and provide benefits for her. However, transgender service members are still living in fear. I am still living in fear of being found out. Nobody should have to live in fear of who they are to defend their country.

Most people are who they want to be inside and out. When those two don’t match and you have to pretend to be something you’re not, it affects your inner being. Most people don’t understand. I wish they could wake up in the opposite body and live life as the opposite sex for one day. Knowing you are a man on the inside but to have people see you as a woman or vice versa is very traumatic. I am expected to behave and act a certain way, but to be afforded the opportunity to do my job as me shouldn’t be this difficult.

I have received many accolades and promotions because I know my job and I do it well. If I am allowed to be myself on the outside, it will not affect my job. In fact, it might even make it better. I will have a sense that the military embraces me totally. In turn, I will want to do more for the institution. I can’t get the medical care I need because it will cause triggers, and I don’t want to lose my job. However, the day that it becomes possible, the shell will reflect the inner me, and that me will be free.”

US Army Family

Service Member:

“First and foremost, I would like to share how the ban affects me immediately. Being in the military is hard enough, but to be transgender in the military is a daily struggle. From the time I drive on-post until the time I drive off, I have to pretend to be someone that I am not. I have to smile in the face of my co-workers and friends and pretend that everything is okay, when in all actuality it is killing me inside. Just small things such as having to answer to the wrong pronouns, and using the female latrines set off my anxiety. I go to work every day in the same uniform as my brothers and sisters and work just as hard as them, only to know that if I admit to being who I am I could be discharged.

The military ban on transgender service members harms my family on a daily basis. This is not just a job but my career we are talking about. I have bills to pay and a loving, supportive wife to take care of. We have to stress day by day whether I will be discharged from the Army and thrown to the side as if I am not good enough to serve my country. I am a soldier, and I am a damn good one. Being transgender has nothing to do with the way I do my job. I am a human being before anything, and I deserve to be treated like one. I have served four years, and I have two years left. I can’t continue to put my transition to my authentic self on hold. I would like nothing more than to reenlist, but I can’t continue to put myself at risk of being discharged for being myself.

It is important to have the ban lifted because everyone should be treated equally, especially those who put everything, including their life, on the line for their country. There are several thousand transgender people serving in the military, and they are forced to hide who they really are to please others. It is simply not fair, and the ban should be lifted immediately. It is time that we come together as a whole and do what’s right. Let people live their lives the way they choose. None of us asked for this life, but it’s what we got and we only live once. I am tired of putting my needs on the back burner because some cannot accept who I am. Let’s drop this ban and for once everyone can be equal as they deserve to be.”

Military Spouse:

“The ban on transgender military affects our lives every single day. There are so many things that would change for the better if this ban were lifted. My spouse signed up for the Army for a new life, to start over and make a difference in the world. Little did he know he would be sacrificing his whole life for this change.

If the ban does not get dropped, we will unfortunately be getting out of the Army in about 2 years when this contract is up. It will be a very hard transition, but we have got to move forward in life, and the Army is holding us back on that. That is just heart breaking to me. We have to lie about who he really is, so we are constantly referred to as a ‘lesbian couple,’ which there is nothing wrong with, but that is just not how we see ourselves. Until my spouse can live life authentically and move forward, that is how it will be.

My spouse honestly wants nothing more than to stay in the Army, get promoted, and live a normal life, but as of right now that is impossible. We would rather just get out the right way and still be able to receive what benefits that we can, without getting kicked out the wrong way. I see him struggle every day with incredibly bad anxiety of just going on post and being called the wrong pronoun, and even something as small as going to a bathroom. Every day that goes by, we hope and pray that some changes will be made so we can continue to live this Army life that we have grown to love, but my spouse being happy means more to us than any of that at this point. So fingers crossed by sharing our story and getting the word out, maybe we will see some changes in the near future.”

THE HARM CONTINUES AFTER ACTIVE DUTY

Upon leaving the military, an estimated 134,000 transgender veterans and their families face post-service challenges and obstacles. In many cases, the impact of serving under the harmful ban leaves a lasting reminder of pain, ignorance and intolerance. These harsh conditions take their toll. The entire family experiences the heartbreaking ordeal of watching their loved one suffer. Often times, they feel just as trapped and helpless, not knowing where to turn or how to track down help.

Transgender veterans and their families are often terrified to come out to the Department of Veterans Affairs. They fear VA guidelines are evocative of the same discriminatory policies that the military enforces. They silently experience the pain, the debilitating depression, the anxiety, and in some cases PTSD.

The characterization of a service member’s discharge can directly affect their access to VA benefits and medical care. This presents hardships and obstacles, leading the way for possible discrimination and harassment when accessing VA and other rightfully earned benefits. Even if the service member decides to medically transition after leaving the military, they still may not be able to fully access all their earned benefits because of inconsistent paperwork and/or IDs.

The difficulty in obtaining military records with updated legal names creates numerous hurdles. Transgender veterans and retirees often experience discrimination and harassment when forced to use their former names to provide their dependents with medical benefits and access to other privileges, like child care, transferred GI Bill benefits, government housing, legal aid, commissary access, Morale, Welfare, and Recreation (MWR) activities, and tax-free shopping on military bases.

CHAMPVA, the Civilian Health Care and Medical Program of the VA, enforces strict exclusions on transgender-related health care for any dependent family members (spouse, child) who are transgender. CHAMPVA policy states “services or supplies related to transsexualism are prohibited.” (38 CFR § 17.272) Due to this discriminatory exclusion, families are forced to seek necessary care with another provider or insurance carrier.

In February 2013, the Veterans Health Administration (VHA) released a directive entitled “Providing Health Care for Transgender and Intersex Veterans” to all VA facilities. This directive is critical to the transgender and intersex veteran accessing and receiving equal access to necessary medical care. VA policy on the care and treatment of transgender and intersex veterans is highlighted, as well as a frequently asked questions section. Despite covered treatment and care for veterans (hormone therapy, speech pathology, mammograms, pap smears, mental health services, preoperative evaluation, post-operative long-term care), the VA continues to enforce transgender-related surgery exclusions. The directive states that the “VA does not provide sex reassignment surgery or plastic reconstructive surgery for strictly cosmetic purposes.” This exclusion creates a hardship for transgender veterans, forcing them to seek necessary care and treatment outside of the VA, causing huge financial hardships, stress, and anxiety. As described previously, the directive does not apply to dependents receiving care through CHAMPVA.

WHAT NEEDS TO HAPPEN?

If citizens are willing to volunteer to put their lives on the line defending our country, they should be given the opportunity to do so if they are qualified for the job. The ability and the desire is all that should matter. No one should be forced to choose between defending the country they love and being true to their authentic self. The outdated regulations serve no purpose and only dehumanize and prevent qualified and capable individuals from enlisting and serving. The ban perpetuates trauma to all those involved, both the service member and their family.

Recent news suggests that there may be a willingness to move forward in the military with the necessary review of regulations regarding transgender exclusion. Over the last few months, several senior leaders and officials have made encouraging statements concerning transgender open service. Deborah Lee James, the U.S. Secretary of the Air Force, publicly commented, “from my point of view, anyone who is capable of accomplishing the job should be able to serve.” Answering a question about transgender service members, Defense Secretary Ashton Carter recently stated, “I don’t think anything but their suitability for service should preclude them.” Master Chief Petty Officer of the Navy (AW/NAC) Mike Stevens also recently expressed support.

In early March, the U.S. Army implemented a new policy making it more difficult to discharge transgender troops. Although they are still unable to serve openly and honestly, now, the Assistant Secretary of the Army for Manpower and Reserve Affairs must approve their removal from service, rather than local unit commanders.

While this movement is encouraging, it is far from enough. Gender non-conformity is no longer considered a mental illness by the psychological and psychiatric medical field, and the military should update its regulations and policies to reflect current recommendations and medical advancements.

Action is critical. The ban is based on outdated regulations and not a federal statute; therefore it does not require an act of Congress to change, but rather a department-level policy review. We continue to urgently call on the Secretary of Defense to order a complete and comprehensive review of the outdated and antiquated medical regulations and policies preventing transgender troops from serving openly and honestly.

The time for full military inclusion is now. Our modern military families have sacrificed enough. It is far past time to stop the needless suffering and honor ALL of our nation’s service members and their families. Until there is comprehensive action, the ban will continue to harm our military families and continue to undermine the stability, cohesion, and effectiveness of the U.S. military.

AMPA Leadership

The American Military Partner Association (AMPA) is the nation’s premier resource and support network for the partners and spouses of LGBT troops and veterans. As a non-partisan, non-profit 501(c)3 organization, AMPA is directed and led by an all-volunteer team of military spouses. Learn more about AMPA's leadership team.